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Therapeutic Lifestyle Changes (TLC) for High Cholesterol

Topic Overview

Therapeutic Lifestyle Changes
(TLC) is a program that can help you lower cholesterol. The lifestyle changes include diet,
exercise, weight loss, and not smoking. Your doctor will want you to follow
TLC even if you are taking cholesterol-lowering medicine. And medicine will work better if you have healthy habits.

This program is recommended
by the National Cholesterol Education Program of the U.S. National Institutes
of Health.footnote 1

TLC diet

People have
varying degrees of success in lowering their cholesterol by changing their diets. Those who are most successful using diet changes
to lower their cholesterol are those who lose excess weight. Diet changes are
usually the first step in lowering cholesterol before medicines are
added.

The diet's main focus is to reduce the amount of saturated fat you
eat, because saturated fat elevates your cholesterol. You can reduce the
saturated fat in your diet by limiting the amount of meat and whole milk products you
eat. Choose low-fat products from those food groups instead. Replace most of
the animal fat in your diet with unsaturated fat, especially monounsaturated
oils, such as olive, canola, or peanut oil. If monounsaturated fat is substituted for
saturated fat, it lowers
LDL ("bad") cholesterol and keeps
HDL ("good") cholesterol up.

What can you eat?

The TLC diet recommends that you eat specific amounts of different types of foods. These amounts are sometimes a percentage of your total calorie intake for each day.

Saturated fat: Less than
7% of total calories

Polyunsaturated fat: Up
to 10% of total calories

Monounsaturated fat: Up to 20% of total calories

Carbohydrate: 50% to 60% of total calories

Soluble fiber: At least 5 to 10 grams a day

Protein: Approximately 15% of total calories

Cholesterol: Less than 200 mg a day

Total calories: Balance calories taken in and calories burned
to reach and stay at a healthy weight.

Your doctor or dietitian might recommend that you add soluble fiber or a cholesterol-lowering margarine to your diet. These might help you lower LDL cholesterol. Soluble fiber is found in foods like oats, beans, and fruit. Cholesterol-lowering margarines contain plant stanols and sterols.

Sample menu

Here is a sample one-day menu. The menu contains approximately 2,200 calories, with 25% of
calories from total fat (5% from saturated fat, 13% from monounsaturated fat,
and 7% from polyunsaturated fat).

Snack

Foods to avoid

Limit saturated fat and oils, such as butter,
bacon drippings, lard, palm oil, and coconut oil. Instead, use soft tub margarine or
vegetable oils, such as olive or canola oil.

Avoid trans fatty acids or partially hydrogenated vegetable oils. These oils go through a process that makes them solid. They're found in some hard margarines, snack crackers, cookies, chips, and
shortenings.

Avoid fast foods like hamburgers, fries,
fried chicken, and tacos. They are high in both total fat and saturated fat.
When you eat out, choose broiled sandwiches or chicken without skin, salads
with low-fat dressing, and foods that aren't fried. Ask the server to leave off
the cheese and high-fat dressings like mayonnaise.

Tips for success

Work with your doctor on a plan to lower your
cholesterol through diet.

Learn how to understand food labels. Look for the
amount of saturated fat per serving, and figure out its percentage of your total
saturated fat intake for the day. "Low-fat" does not always mean what it seems.
Some labels measure fat content by weight rather than as a percentage of the
calories in a serving.

Exercise. Always talk to your doctor
before you start an exercise program.

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How this information was developed to help you make better health decisions.